Is Your Organization Showing Signs of HEART Disease?
We all know the symptoms of physical heart disease: shortness of breath, fatigue, chest pain. Left untreated, they can lead to a critical event — sometimes fatal, often preventable. That’s why physicians are trained to look beyond the surface symptoms, assessing vital signs to uncover what's really going on inside the body.
But what if your organization were the patient?
Would you recognize the early signs of a failing HEART?
Toxic culture. Widespread disengagement. Finger-pointing instead of ownership. Burnout. Siloed teams. These aren’t just workplace annoyances — they’re symptoms of HEART disease within your organization. And just like physical illness, organizational HEART disease rarely resolves on its own. Without proper diagnosis and treatment, it spreads — quietly undermining performance, morale, and long-term viability.
So how can you tell if your organization is in trouble? And more importantly, how do you intervene?
Diagnosing the Organizational HEART
In the Vital Signs book series, we propose a structured framework called the HEART Protocol — a priority diagnostic and treatment guide for organizational health.
Much like a clinician starts with vital signs, this protocol begins by examining five core components of a healthy organization:
H – Healthy Strategic Culture
E – Engaged Workforce
A – Accountable Individuals
R – Resilient Capability
T – Team-Oriented Collaboration
These five elements form the organizational HEART. And when one or more begins to fail, the entire body — or in this case, the business — suffers.
Let’s look more closely at the early signs of “HEART disease” and how they might be showing up in your organization.
1. Unhealthy Strategic Culture
📉 Symptom: Confusion, misalignment, and reactive decision-making.
A healthy organization is anchored by a clear strategy and an aligned culture that supports execution. But when strategy is vague or ever-shifting — or when culture contradicts the stated values — employees lose trust. Decision-making becomes inconsistent. Resources are misallocated. Leaders say one thing but reward another.
You may hear comments like:
“We’ve had three new initiatives this quarter alone — which one actually matters?”
Or worse:
“We say we value teamwork, but promotions go to people who fly solo and grab the spotlight.”
These are symptoms of a fractured organizational HEART — one that beats to competing rhythms.
2. Disengaged Workforce
📉 Symptom: Low morale, quiet quitting, minimal discretionary effort.
Engagement is more than employee satisfaction — it’s about energy, purpose, and emotional commitment. When people feel disconnected from the mission or unclear about their impact, they do just enough to get by.
In disengaged environments, you might notice:
Increased absenteeism
Decreased innovation
Resistance to change
A culture of cynicism
You don’t need a mass exodus to see the problem. Sometimes the biggest danger is the people who stay but have emotionally checked out.
3. Lack of Accountability
📉 Symptom: Missed deadlines, blame-shifting, and performance gaps.
When accountability is absent, results suffer. But more than that, trust erodes. A lack of accountability shows up as:
Projects that stall with no ownership
Leaders who avoid difficult conversations
A growing gap between intention and execution
As one client once told me:
“People show up for meetings, but no one owns the outcome.”
This isn’t just poor project management — it’s a warning sign of HEART failure at the individual and team levels.
4. Eroded Resilience
📉 Symptom: Burnout, brittle systems, and fear of change.
COVID-19 taught us that resilience is no longer optional. Organizations must adapt quickly, recover stronger, and prepare for disruption. If your systems — or your people — snap under pressure instead of flexing and recovering, you may be dealing with resilience fatigue.
Ask yourself:
Do teams respond to setbacks with learning or blame?
Are your processes adaptable or stuck in pre-crisis mode?
Do leaders model optimism, or has the culture defaulted to survival mode?
If resilience is low, even small changes can feel overwhelming. The organization becomes fragile — vulnerable to every new wave of pressure.
5. Siloed, Dysfunctional Teams
📉 Symptom: Poor collaboration, turf wars, and communication breakdowns.
When teams don’t trust one another — or worse, compete against one another — organizational performance stalls. A team-oriented culture is the final vital sign of HEART health. Without it, even talented individuals can’t function at full capacity.
You might hear:
“That’s not my department’s problem.”
“We weren’t included in that decision.”
“We’re duplicating work because we don’t talk.”
In a healthy organization, teams share knowledge, support one another, and rally around shared goals. If that’s missing, it’s time to intervene.
Treat the Disease — Don’t Just Mask the Symptoms
Too often, leaders address these issues as isolated problems:
“Let’s do a culture workshop.”
“Let’s implement an engagement survey.”
“Let’s try accountability coaching.”
These are not bad ideas. But they are insufficient if they don’t address the systemic breakdown of HEART health.
The HEART Protocol isn’t a one-time solution — it’s an ongoing leadership practice. It helps you:
Identify early warning signs
Understand which systems are compromised
Apply targeted, evidence-based interventions
Monitor progress and course-correct as needed
Just like treating a physical heart condition, this requires commitment, time, and follow-through.
So… Is Your Organization at Risk?
Here are a few diagnostic questions to consider:
Are your people energized by a clear mission — or confused by shifting priorities?
Are teams accountable for results — or just busy?
Do people bounce back from setbacks — or break down?
Are teams collaborating — or just coexisting?
If any of these questions give you pause, your organization may be showing signs of HEART disease.
The good news? It’s treatable. And with the right protocol in place, preventable. To learn more, visit vitalsigns-book.com.